Detection of Bartonella quintana in African body and head lice

Bartonella quintana detection among arthropods and their hosts: a systematic review and meta-analysis

BACKGROUND

Bartonella quintana is a body louse-borne bacterium causing bacteremia and infective endocarditis. We aimed to describe B. quintana detection among arthropods and their hosts.

METHODS

We searched databases in PubMed Central/MEDLINE, Scopus, Embase, and Web of Science from January 1, 1915 (the year of B. quintana discovery) to January 1, 2024, to identify publications containing specific search terms relating to B. quintana detection among arthropods. Descriptive statistics and meta-analysis of pooled prevalence using random-effects models were performed for all arthropods and body and head lice.

RESULTS

Of 1265 records, 62 articles were included, describing 8839 body lice, 4962 head lice, and 1692 other arthropods, such as different species of fleas, bedbugs, mites, and ticks. Arthropods were collected from 37 countries, of which 28 had arthropods with B. quintana DNA. Among articles that reported B. quintana detection among individual arthropods, 1445 of 14,088 (0.1026, 95% CI [0.0976; 0.1077]) arthropods tested positive for B. quintana DNA, generating a random-effects model global prevalence of 0.0666 (95% CI [0.0426; 0.1026]). Fifty-six studies tested 8839 body lice, of which 1679 had B. quintana DNA (0.1899, 95% CI [0.1818; 0.1983]), generating a random-effects model pooled prevalence of 0.2312 (95% CI [0.1784; 0.2843]). Forty-two studies tested 4962 head lice, of which 390 head lice from 20 studies originating from 11 different countries had B. quintana DNA (0.0786, 95% CI [0.0713; 0.0864]). Eight studies detected B. quintana DNA exclusively on head lice. Five studies reported greater B. quintana detection on head lice than body lice; all originated from low-resource environments.

CONCLUSIONS

Bartonella quintana is a vector-borne bacterium with a global distribution, disproportionately affecting marginalized populations. Bartonella quintana DNA has been detected in many different arthropod species, though not all of these arthropods meet criteria to be considered vectors for B. quintana transmission. Body lice have long been known to transmit B. quintana. A limited number of studies suggest that head lice may also act as possible vectors for B. quintana in specific low-resource contexts.

Hidden Burden of Bartonella quintana on the African Continent: Should the Bacterial Infection Be Considered a Neglected Tropical Disease?

Bartonella quintana is a louse-borne gram-negative bacillus that remains a poorly characterized cause of bacteremia, fever, and infective endocarditis. Due to the link with pediculosis, B quintana transmission is tied to poverty, conflict, overcrowding, and inadequate water access to maintain personal hygiene. Although these risk factors may be present globally, we argue that a substantial burden of undocumented B quintana infection occurs in Africa due to the high prevalence of these risk factors. Here, we describe the neglected burden of B quintana infection, endocarditis, and vector positivity in Africa and evaluate whether B quintana meets criteria to be considered a neglected tropical disease according to the World Health Organization.

POPULATION STRUCTURE AND BARTONELLA QUINTANA IN HEAD AND BODY LICE IN POKHARA, NEPAL (ANOPLURA: PEDICULIDAE)

This study examined the population structure of head and body lice infesting a random sample of people in Pokhara, Nepal during 2003, 2004, and 2005. A total of 106 participants (6 to 72 yr old, median = 12) volunteered to have lice collected from their heads and clothing. Most participants (70%) harbored only head lice, some (15%) had only body lice, and some (15%) had concurrent infestations of head and body lice (dual infestations). A total of 1,472 lice was collected. Significantly more nymphs were collected than adult lice. Louse populations were generally small (geometric mean = 8.8 lice per person) but a few participants harbored larger louse populations (maximum = 65 lice). People with dual infestations harbored significantly more lice than people with single infestations; however, there was no difference in the infestation intensities between people infested with head lice only vs. those infested with body lice only. Male participants harbored significantly more lice than did females. There were no significant differences in infestation intensity due to participant age or their socioeconomic level. The sex ratio of adult lice was increasingly female biased with increasing adult louse density. Infection of lice with Bartonella quintana was low (ca. 1.5%). Pediculosis is a common problem in urban Nepal.

Phylogenetic and network analysis of Pediculus humanus in Nigeria reveal the presences of clade E body lice and novel haplotypes

An investigation was conducted for the first time to determine the prevalence and genetic diversity of human lice, for the first time in Nigeria, using conventional PCR and sequencing methods. Three mitochondrial genes, cytochrome oxidase subunit 1 (cox1), cytochrome b (cytb), and 12S rRNA of Nigerian human lice, were amplified, sequenced, and analyzed. Overall, high prevalence (72.5%; 103/142) of lice infestation was recorded among the examined volunteers. Head lice infestation was more common 63 (61.2%) than body lice infestation 34 (33.0%). Co-infestation with both head and body lice was recorded in six humans (5.8%). The Nigerian human lice specimens were placed mostly into clade A with few in clade E, including body lice for the first time. Six, three, and eight haplotypes of Nigerian human lice were obtained for the cytb, cox1, and 12S rRNA genes, respectively. Additionally, one (E51), three (A31, A32, and E5), and six (A20, A21, A23, A24, A30, and E1) novel haplotypes were recorded for cox1, cytb, and 12S rRNA, respectively, from the Nigerian specimens which were corroborated by the ML phylogenetic trees and MJ network analyses. Genetic diversity indices indicate minimal variation in the parameters analyzed among the clades of the three genes. However, a statistically significant Snn test, negative Tajima's D test for clade A (cox1 and 12S rRNA genes), and negative Fu and Li's D test in clade A for cox1 gene indicate a geographical structure and the signature of population expansion of the Nigerian human lice. The findings from this study provide additional data on the human lice structure in Africa.

Head lice as vectors of pathogenic microorganisms

Body lice and head lice are the most common ectoparasites of humans. Head lice (Pediculus humanus capitis) occur worldwide in children and their caretakers, irrespective of their social status. In contrast, body lice (Pediculus humanus corporis) are confined to marginalized population groups in countries of the Global South, homeless people, and refugees. Body lice are known to transmit an array of bacterial pathogens, such as R. prowazekii, R. rickettsii, C. burneti, B. quintana, B. recurrentis, and Y. pestis. The vector capacity of head lice is still a matter of debate. The objective of the review was to scrutinize the existing evidence on the vector capacity of head lice for the transmission of bacterial pathogens. The PUBMED database was searched using a combination of the terms "pediculus humanus" OR "body lice" OR "head lice" AND "pathogen" OR "Rickettsia prowazekii" OR "Bartonella quintana" OR "Borrelia recurrentis" OR "Coxiella burneti" without a time limit. Data from epidemiological studies as well as historical observations demonstrate that body lice and head lice can carry the same array of pathogens. Since the presence of a bacterial pathogen in an arthropod is not sufficient to state that it can be transmitted to humans, and since experimental models are lacking, as yet one cannot conclude with certainty that head lice serve as vectors, although this review presents circumstantial evidence that they do. Adequately designed experimental and epidemiological studies are needed to ascertain the exact transmission potential of head lice.

Emerging bacterial infectious diseases/pathogens vectored by human lice

Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.

Case series of 12 Bartonella quintana endocarditis from the Southwest Indian Ocean

BACKGROUND

Bartonella spp. are fastidious bacteria frequently identified as the cause of blood culture-negative (BCN) endocarditis. However, Bartonella infections are difficult to diagnose in routine laboratory testing and their incidence is probably underestimated. We investigated the epidemiological and clinical features of Bartonella endocarditis cases diagnosed between 2009 and 2021 on Reunion Island (Southwest Indian Ocean).

METHOD

We retrospectively included all patients diagnosed with Bartonella endocarditis at Reunion Island University Hospital during this period. Endocarditis was diagnosed on the basis of microbiological findings, including serological tests (IFA) and PCR on cardiac valves, and the modified Duke criteria. We used then the multispacer typing (MST) method to genotype the available Bartonella strains.

FINDINGS

We report 12 cases of B. quintana endocarditis on Reunion Island (83.3% in men, median patient age: 32 years). All the patients originated from the Comoros archipelago. The traditional risk factors for B. quintana infection (homelessness, alcoholism, exposure to body lice) were absent in all but two of the patients, who reported head louse infestations in childhood. Previous heart disease leading to valve dysfunction was recorded in 50% of patients. All patients underwent cardiac valve surgery and antimicrobial therapy with a regimen including doxycycline. All patients presented high C-reactive protein concentrations, anemia and negative blood cultures. The titer of IgG antibodies against Bartonella sp. exceeded 1:800 in 42% of patients. Specific PCR on cardiac valves confirmed the diagnosis of B. quintana endocarditis in all patients. Genotyping by the MST method was performed on four strains detected in preserved excised valves and was contributive for three, which displayed the MST6 genotype.

CONCLUSIONS

Bartonella quintana is an important cause of infective endocarditis in the Comoros archipelago and should be suspected in patients with mitral valve dysfunction and BCN from this area.

Head Lice Infestation in Pre-High School Girls, Lak Hok Suburban Area, Pathum Thani Province, in Central Thailand

This is a cross-sectional descriptive survey to determine the prevalence of lice infestation in a pre-high school, Lak Hok subdistrict, Pathum Thani Province, in central part of Thailand. The knowledge, attitudes, and practices of parents/guardians toward head lice in female children during February-April 2020 were evaluated. A total of 83 out of 111 parents (74.8%) agreed to complete consent forms and questionnaires. The prevalence of pediculosis found in this study was 68.7%. The infestation was found in the primary school level (87.5%), which was significantly higher than pre-primary school (29.6%; p < 0.05). Itching scalp was revealed in 93.0% of pediculosis. The results showed that occupation, religion, education, and income showed no significant difference between lice infested and non-infested students (p > 0.05). There was no significant association between sex, occupation, religion, education, income, status of parents, and family size among lice infested and non-infested students (p > 0.05). The parents/guardians showed the middle level of knowledge concerning with pediculosis capitis (66.8%). The lack of knowledge leading, first, to the belief that pediculosis does not need any treatment (89.2%), followed by boys getting head lice more frequently than girls (85.5%), and the belief that sharing infested combs, brushes, or hair ribbons does not result in lice transmission (79.9%). More than 75% of the parents/guardians had experienced infestation of head lice and showed themselves willing and able to diagnose and treat their family. However, 50.6% of them did not feel shame when their children were infested with head lice. Children washing their hair by themselves were found to be a significant factor in infestation (88.5%). High rate of pediculosis in this suburban school needs more intensive care by parents/guardians and teachers. Furthermore, improvement strategies to prevent and control lice in the school need to be more specifically planned and scheduled by teachers and health administrators.

Lice and lice-borne diseases in humans in Africa: a narrative review

Lice are host-specific insects. Human lice include Pediculus humanus humanus (body lice) which are known to be vectors of serious human bacterial infectious diseases including epidemic typhus, relapsing fever, trench fever and plague; Pediculus humanus capitis (head lice) that frequently affect children; and Pthirus pubis, commonly known as crab lice. In Africa, human infections transmitted by lice remained poorly known and therefore, underestimated, perhaps due to the lack of diagnostic tools and professional knowledge. In this paper we review current knowledge of the microorganisms identified in human lice in the continent of Africa, in order to alert health professionals to the importance of recognising the risk of lice-related diseases.

Serologic study of Bartonella sp. infection among human population of Southern Spain

INTRODUCTION

The purpose of this study was to determine the prevalence of IgG antibodies against Bartonella sp. in a randomly selected sample from the population of the patients of North Sanitary District of Jaén.

METHODS

We used a commercially available immunofluorescent test (Focus-Technology IFA Bartonella quintana and B. henselae test).

RESULTS

Six hundred five healthy individuals were divided by sex into three age groups. We detected that 13.55% and 11.07% subjects were IgG seropositive to B. henselae and B. quintana, respectively.

CONCLUSIONS

Our data show that the prevalence of both Bartonella species in Andalusia (Southern Spain) is relatively high. No statistical difference in the seropositivity was observed among these groups. In both cases, the IgG antibody titers ranged from 1/128 to 1/512.

Prediction of Novel Drug Targets and Vaccine Candidates against Human Lice (Insecta), Acari (Arachnida), and Their Associated Pathogens

The emergence of drug-resistant lice, acari, and their associated pathogens (APs) is associated with economic losses; thus, it is essential to find new appropriate therapeutic approaches. In the present study, a subtractive proteomics approach was used to predict suitable therapeutics against these vectors and their infectious agents. We found 9701 proteins in the lice (Pediculus humanus var. corporis) and acari (Ixodes scapularis, Leptotrombidium deliense), and 4822 proteins in the proteomes of their APs (Babesia microti, Borreliella mayonii, Borrelia miyamotoi, Borrelia recurrentis, Rickettsia prowazekii, Orientia tsutsugamushi str. Boryong) that were non-homologous to host proteins. Among these non-homologous proteins, 365 proteins of lice and acari, and 630 proteins of APs, were predicted as essential proteins. Twelve unique essential proteins were predicted to be involved in four unique metabolic pathways of lice and acari, and 103 unique proteins were found to be involved in 75 unique metabolic pathways of APs. The sub cellular localization analysis of 115 unique essential proteins of lice and acari and their APs revealed that 61 proteins were cytoplasmic, 42 as membrane-bound proteins and 12 proteins with multiple localization. The druggability analysis of the identified 73 cytoplasmic and multiple localization essential proteins revealed 22 druggable targets and 51 novel drug targets that participate in unique pathways of lice and acari and their APs. Further, the predicted 42 membrane bound proteins could be potential vaccine candidates. Screening of useful inhibitors against these novel targets may result in finding novel compounds efficient for the control of these parasites.

Bartonella quintana as a cause for prosthetic valve endocarditis and post-sternotomy mediastinitis

An otherwise healthy patient, with minimal clinical, biochemical and peroperative signs of infection, was diagnosed with Bartonella quintana prosthetic valve endocarditis by 16S PCR. The patient subsequently developed a post-sternotomy mediastinitis and Bartonella quintana was the only detected pathogen. Bartonella quintana can cause severe infections in individuals not classically at risk, and may be missed in the routine diagnostic work-up of endocarditis.

Molecular Characterization and Genetic Diversity of Haplogroup E Human Lice in Guinea, West Africa

Pediculus humanus capitis, the head louse, is an obligate blood-sucking ectoparasite that occurs in six divergent mitochondrial clades (A, D, B, F, C and E). Several studies reported the presence of different pathogenic agents in head lice specimens collected worldwide. These findings suggest that head louse could be a dangerous vector and a serious public health problem. Herein, we aimed to study the mitochondrial genetic diversity, the PHUM540560 gene polymorphisms profile of head lice collected in Guinea, as well as to screen for their associated pathogens. In 2018, a total of 155 head lice were collected from 49 individuals at the Medicals Centers of rural (Maférinyah village) and urban (Kindia city) areas, in Guinea. Specimens were subjected to a genetic analysis and pathogens screening using molecular tools. Results showed that all head lice belonged to eight haplotypes in the E haplogroup, with six newly identified for the first time. The study of the PHUM540560 gene polymorphisms of our clade E-head lice revealed that 82.5% exhibited the same polymorphism profile as the previously reported clade A-body lice. Screening for targeted pathogens revealed the presence of Acinetobacter spp., while sequencing highlighted the presence of several species, including Acinetobacter baumannii, Acinetobacter nosocomialis, Acinetobacter variabilis, Acinetobacter towneri and for the first time Acinetobacter haemolyticus. Our study is the first to report the existence of the Guinean haplogroup E, the PHUM540560 gene polymorphism profile as well as the presence of Acinetobacter species in head lice collected from Guinea.

Serologic study of Bartonella sp. infection among human population of Southern Spain

INTRODUCTION

The purpose of this study was to determine the prevalence of IgG antibodies against Bartonella sp. in a randomly selected sample from the population of the patients of North Sanitary District of Jaén.

METHODS

We used a commercially available immunofluorescent test (Focus-Technology IFA Bartonella quintana and B. henselae test).

RESULTS

Six hundred five healthy individuals were divided by sex into three age groups. We detected that 13.55% and 11.07% subjects were IgG seropositive to B. henselae and B. quintana, respectively.

CONCLUSIONS

Our data show that the prevalence of both Bartonella species in Andalusia (Southern Spain) is relatively high. No statistical difference in the seropositivity was observed among these groups. In both cases, the IgG antibody titers ranged from 1/128 to 1/512.

Molecular identification of head lice collected in Franceville (Gabon) and their associated bacteria

BACKGROUND

Pediculus humanus, which includes two ecotypes (body and head lice), is an obligate bloodsucking parasite that co-evolved with their human hosts over thousands of years, thus providing a valuable source of information to reconstruct the human migration. Pediculosis due to head lice occurred each year throughout the world and several pathogenic bacteria, which are usually associated with body lice, are increasingly detected in them. In Gabon, where this pediculosis is still widespread, there is a lack of data on genetic diversity of head lice and their associated bacteria.

METHODS

This study aimed to investigate the phylogeny of head lice collected in Gabon and their associated bacteria, using molecular tools. Between 26 March and 11 April 2018, 691 head lice were collected from 86 women in Franceville. We studied the genetic diversity of these lice based on the cytochrome b gene, then we screened them for DNA of Bartonella quintana, Borrelia spp., Acinetobacter spp., Yersinia pestis, Rickettsia spp., R. prowazekii, Anaplasma spp. and C. burnetii, using real time or standard PCR and sequencing.

RESULTS

Overall 74.6% of studied lice belonged to Clade A, 25.3% to Clade C and 0.1% to Clade E. The phylogenetic analysis of 344 head lice yielded 45 variable positions defining 13 different haplotypes from which 8 were novel. Bacterial screening revealed the presence of Borrelia spp. DNA in 3 (0.4%) of 691 head lice belonging to Clade A and infesting one individual. This Borrelia is close to B. theileri (GenBank: MN621894). Acinetobacter spp. DNA has been detected in 39 (25%) of the 156 screened lice; of these 13 (8.3%) corresponded to A. baumannii. Acinetobacter nosocomialis (n = 2) and A. pittii (n = 1) were also recorded.

CONCLUSIONS

To of our knowledge, this study is the first to investigate the genetic diversity of head lice from Gabon. It appears that Clade C is the second most important clade in Gabon, after Clade A which is known to have a global distribution. The detection of Borrelia spp. DNA in these lice highlight the potential circulation of these bacteria in Gabon.

Knowledge, Attitude, and Practice of Pediculus Capitis Prevention and Control and Their Predictors among Schoolchildren in Woreta Town, Northwest Ethiopia, 2018: A School-Based Cross-Sectional Study

Background

Pediculus capitis is a human head lice infestation, a major public health issue that is most prevalent in resource-limited countries globally. The current study aimed to assess the knowledge, attitude, and practice of pediculus capitis prevention and control and their predictors among schoolchildren in North West Ethiopia.

Methods

About 402 randomly selected schoolchildren from three schools in Woreta town participated in the study from April to June 2018. The outcomes of this study were knowledge, attitude, and self-reported practice of schoolchildren about pediculus capitis prevention and control. We used EPI Info 7.1 and SPSS 21 software for data entry and analysis, respectively. Binary logistic regression was employed to test the association of covariates with the outcome/response variables. Variables with a p value <0.2 during the bivariable binary logistic regression analysis were included in the multivariable binary logistic regression analysis. Variables with p value <0.05 were declared as significantly associated with outcomes.

Results

The mean age of the study participants was 10.19 (±1.62) years. About 58.8%, 45.8%, and 78.6% of the schoolchildren had better self-reported pediculus capitis prevention knowledge, attitude, and practice, respectively. Age of children [9 to 11 years (AOR = 2.24, 95% C.I (1.10, 4.55)) and>12 years (AOR = 3.84, 95% C.I (1.56, 9.46))], better practice (AOR = 2.93, 95% C.I (1.39, 6.18)), and those who were not infested (AOR = 2.25, 95% C.I (1.14, 4.44)) were predictors of knowledge regarding pediculus capitis prevention. Better practice (AOR = 4.33, 95% C.I (1.69, 11.09)) and absence of infestation (AOR = 2.97, 95% C.I (1.64, 5.36)) were predictors of attitude of schoolchildren about pediculus capitis prevention. Number of students in a class [51 to 56 students per classroom, AOR = 4.61, 95% C.I (1.83, 11.67); 57 to 58 students per classroom, AOR = 8.18, 95% C.I (2.73, 24.46)], less than five family size (AOR = 2.37, 95% C.I (1.24, 4.54)), better knowledge (AOR = 2.93, 95% C.I (1.32, 6.50)), desirable attitude (AOR = 4.24, 95% C.I (1.60, 11.23)), and absence of infestation (AOR = 3.52, 95% C.I (1.22, 10.15)) were predictors of self-reported pediculus capitis prevention practice.

Conclusion

The knowledge, attitude, and practice of schoolchildren regarding pediculus capitis prevention and control were not satisfactory. To bring change, intensive efforts on factors associated with the knowledge, attitude, and practice should be encouraged.

Molecular detection of Rickettsia spp., Borrelia spp., Bartonella spp. and Yersinia pestis in ectoparasites of endemic and domestic animals in southwest Madagascar

Little is known about the presence of vector-borne bacteria in southwest Madagascar. Anthropogenic alteration of natural habitats represents an important driver for the emergence of new diseases. Especially the involvement of livestock and the involuntary maintaining of invasive synanthropic animals (particularly rats) facilitate disease transmission from wildlife to humans and associated animals and vice versa. The dissemination or acquisition of ectoparasites is most likely in regions where human/wildlife contact is increasing. Little is known about the presence of vector-borne bacteria in southwest Madagascar. In 2016 and 2017, ectoparasites were collected from various introduced (cattle and goats, cats, dogs and chicken, rats and mice) and native animal species (mouse lemurs [Microcebus griseorufus], Grandidier's mongooses [Galidictis grandidieri], bastard big-footed mice [Macrotarsomys bastardi], greater hedgehog tenrecs [Setifer setosus] and lesser hedgehog tenrecs [Echinops telfairi]) in the northern portion of Tsimanampetsotsa National Park and the adjacent littoral region. Thirteen species of blood-feeding ectoparasites (235 individuals of ticks [5 species], 414 lice [4 spp.] and 389 fleas [4 spp.]) were investigated for the presence and identity of rickettsiae, borreliae, bartonellae and Yersinia pestis using PCR techniques. Rickettsia spp. were detected in every single ectoparasite species (Amblyomma variegatum, A. chabaudi, Rhipicephalus microplus, Haemaphysalis simplex, Argas echinops, Ctenocephalides felis, Echidnophaga gallinacea, Pulex irritans, Xenopsylla cheopis, Haematopinus quadripertusus, Linognathus africanus, L. vituli, Lemurpediculus verruculosus). Lice and ticks were found harboring rickettsiae identified as Rickettsia africae, while Rickettsia felis-like bacteria were associated with fleas. Borrelia spp. were detected in 5% of H. simplex and 1% of R. microplus ticks. Bartonella spp. were detected in 40% of H. quadripertusus pools and in 5% of L. verruculosus pools. Y. pestis was detected in X. cheopis and E. gallinacea fleas collected from a rat. This study presents the detection of a broad spectrum of vector-borne bacteria including potential pathogens, and an unexpected finding of Y. pestis far off the known plague foci in Madagascar.

Molecular investigation and genetic diversity of Pediculus and Pthirus lice in France

BACKGROUND

Humans are parasitized by three types of lice: body, head and pubic lice. As their common names imply, each type colonizes a specific region of the body. The body louse is the only recognized disease vector. However, an increasing awareness of head lice as a vector has emerged recently whereas the status of pubic lice as a vector is not known since it has received little attention.

METHODS

Here, we assessed the occurrence of bacterial pathogens in 107 body lice, 33 head lice and 63 pubic lice from Marseille and Bobigny (France) using molecular methods.

RESULTS

Results show that all body lice samples belonged to the cytb Clade A whereas head lice samples belonged to Clades A and B. DNA of Bartonella quintana was detected in 7.5% of body lice samples and, for the first time to our knowledge, in 3.1% of pubic lice samples. Coxiella burnetii, which is not usually associated with transmission by louse, was detected in 3.7% of body lice samples and 3% of head lice samples. To the best of our knowledge, this is the first report of C. burnetii in Pediculus lice infesting humans in France. Acinetobacter DNA was detected in 21.5% of body lice samples, 6% of head lice samples and 9.5% of pubic lice samples. Five species were identified with A. baumannii being the most prevalent.

CONCLUSIONS

Our study is the first to report the presence of B. quintana in pubic lice. This is also the first report of the presence of DNA of C. burnetii in body lice and head lice in France. Further efforts on the vectorial role of human lice are needed, most importantly the role of pubic lice as a disease vector should be further investigated.

Pediculosis capitis y transmisión potencial de enfermedades infecciosas reemergentes en Colombia. Revisión de la literatura

Introducción. La infestación por piojos de la cabeza en humanos (Pediculus humanus capitis) se conoce como pediculosis capitis. Estos parásitos pueden ser vectores de enfermedades infecciosas con potencial reemergente.Objetivos. Revisar la literatura actual sobre las enfermedades infecciosas transmitidas por piojos de la cabeza y realizar una breve descripción de sus manifestaciones clínicas.Materiales y métodos. Se realizó una revisión de la literatura en PubMed, ScienceDirect, SciELO y Redalyc mediante la siguiente estrategia de búsqueda: años de publicación: 1938 a 2019; idioma: inglés y español; términos de búsqueda: “Pediculus”, “lice infestations”, “bacteria”, “emerging communicable diseases”, “Rickettsia”, “Bartonella”, “Borrelia”, “Acinetobacter”, “Yersinia“, and “Colombia”, y sus equivalentes en español.Resultados. De los 110 artículos incluidos, la mayoría correspondió a investigaciones originales (48.2%). A nivel mundial, numerosos estudios han reportado la transmisión de Rickettsia prowazekii, Bartonella quintana, Borrelia recurrentis, Staphylococcus aureus, Acinetobacter baumannii y Yersinia pestis, entre otras bacterias, por los piojos de la cabeza y del cuerpo en humanos.Conclusiones. Aunque las enfermedades infecciosas transmitidas por piojos de la cabeza son raras, guardan potencial reemergente en poblaciones afectadas por migraciones humanas, crisis sociopolíticas, indigencia e inmunosupresión. En Colombia no se han realizado investigaciones sobre la transmisión de estas enfermedades por Pediculus spp., por lo que se sugiere que en estudios futuros se determine la prevalencia y los aspectos epidemiológicos de las enfermedades transmitidas por piojos de la cabeza en población colombiana.

Where Are We With Human Lice? A Review of the Current State of Knowledge

Pediculus humanus is an obligate bloodsucking ectoparasite of human that includes two ecotypes, head louse and body louse, which differ slightly in morphology and biology, but have distinct ecologies. Phylogenetically, they are classified on six mitochondrial clades (A, B, C, D, E, and F), head louse encompasses the full genetic diversity of clades, while body louse belongs to clades A and D. Recent studies suggested that not only body louse, but also head louse can transmit disease, which warrants greater attention as a serious public health problem. The recent sequencing of body louse genome confirmed that P. humanus has the smallest genome of any hemimetabolous insect reported to date, and also revealed numerous interesting characteristics in the nuclear and mitochondrial genomes. The transcriptome analyses showed that body and head lice were almost genetically identical. Indeed, the phenotypic flexibility associated with the emergence of body lice, is probably a result of regulatory changes, perhaps epigenetic in origin, triggered by environmental signals. Current lice control strategies have proven unsuccessful. For instance, ivermectin represents a relatively new and very promising pediculicide. However, ivermectin resistance in the field has begun to be reported. Therefore, novel opportunities for pest control strategies are needed. Our objective here is to review the current state of knowledge on the biology, epidemiology, phylogeny, disease-vector and control of this fascinating and very intimate human parasite.

Detection of bacterial pathogens in clade E head lice collected from Niger's refugees in Algeria

Background

Head lice, Pediculus humanus capitis, are obligate blood-sucking parasites. Phylogenetically, they occur in five divergent mitochondrial clades (A, D, B, C and E), each having a particular geographical distribution. Recent studies have revealed that head lice, as is the case of body lice, can act as a vector for louse-borne diseases. Here, we aimed to study the genetic diversity of head lice collected from Niger’s refugees (migrant population) arriving in Algeria, northern Africa, and to look for louse-borne pathogens. Comparative head lice samples collected from indigenous population of schoolchildren (non-immigrant) were also analyzed to frame the study.

Results

In this study, 37 head lice samples were collected from 31 Nigerien refugees, as well as 45 head lice from 27 schoolchildren. The collection was established in three localities of eastern Algiers, north Algeria. Quantitative real-time PCR screening of pathogens bacteria and the genetic characterisation of the head lice satut were performed. Through amplification and sequencing of the cytb gene, results showed that all head lice of Nigerien refugees 37/82 (45.12%) belonged to clade E with the presence of four new haplotypes, while, of the 45 head lice of schoolchildren, 34/82 lice (41.46%) belonged to clade A and 11/82 (13.41%) belonged to clade B. Our study is the first to report the existence of clade E haplogroup in Nigerien head lice. DNA of Coxiella burnetii was detected in 3/37 (8.10%) of the head lice collected from 3 of the 31 (9.67%) migrant population. We also revealed the presence of Acinetobacter DNA in 20/37 (54.05%) of head lice collected from 25/31 (80.64%) of the Nigerien refugees, and in 25/45 (55.55%) head lice collected from 15/27 (55.55%) schoolchildren. All positive Nigerien-head lice for Acinetobacter spp. were identified as A. baumannii, while positive schoolchildren-head lice were identified as A. johnsonii 15/25 (60%), A. variabilis 8/25 (32%) and A. baumannii 2/25 (8%).

Conclusions

Based on these findings from head lice collected on migrant and non-migrant population, our results show, for the first time, that head lice from Niger belong to haplogroup E, and confirm that the clade E had a west African distribution. We also detected, for the first time, the presence of C. burnetii and A. baumannii in these Nigerien head lice. Nevertheless, further studies are needed to determine whether the head lice can transmit these pathogenic bacteria from one person to another.

Effect of a health education program on reduction of pediculosis in school girls at Amphoe Muang, Khon Kaen Province, Thailand

BACKGROUND

Pediculosis caused by head lice (Pediculus humanus capitis) infestation is still an important health problem in schoolchildren, especially girls, worldwide, including in Thailand. Although pediculicidal agents effectively kill head lice, the re-infestation rate is still high. Thus, prevention is an important strategy for any sustainable control program. We aimed to develop and evaluate the efficacy of a health education program for increasing knowledge, changing attitudes and promoting preventive practices to reduce prevalence of pediculosis among school girls in Amphoe Muang, Khon Kaen, northeastern Thailand.

METHODOLOGY

Six schools were selected using multistage simple randomization and were allocated into intervention or control groups. A total of 267 girls was enrolled from these schools. A "knowledge, attitude and practice" (KAP) questionnaire, consent forms and health education materials were constructed and tested by experts and in one pilot school before the main investigation. Baseline prevalence of adult lice and nits was determined. The health education package was given only to the intervention group. The KAP questionnaire was re-evaluated at two months after intervention.

RESULTS

At baseline, the prevalence and intensity of head lice infestation, and the KAP scores did not differ significantly between the two groups. After re-evaluation at two months, the KAP score was significantly greater in the intervention group. A significant decrease of the infestation rate from 59% to 44% was observed in the intervention group, whereas infestation increased in the control group (from 56% to 65%). The incidence of new cases in the intervention group (6.14%) was lower than in the control group (12.62%).

CONCLUSION

These findings indicated that the newly-established health education package is an effective tool for increasing KAP and reducing head lice infestation in school girls. Efforts to combat pediculosis in schoolchildren elsewhere may consider including this, or a similar, health education package in their programs.

Body lice of homeless people reveal the presence of several emerging bacterial pathogens in northern Algeria

BACKGROUND

Human lice, Pediculus humanus, are obligate blood-sucking parasites. Body lice, Pediculus h. humanus, occur in two divergent mitochondrial clades (A and D) each exhibiting a particular geographic distribution. Currently, the body louse is recognized as the only vector for louse-borne diseases. In this study, we aimed to study the genetic diversity of body lice collected from homeless populations in three localities of northern Algeria, and to investigate louse-borne pathogens in these lice.

METHODOLOGY/PRINCIPAL FINDINGS

In this study, 524 body lice specimens were collected from 44 homeless people in three localities: Algiers, Tizi Ouzou and Boumerdès located in northern Algeria. Duplex clade specific real-time PCRs (qPCR) and Cytochrome b (cytb) mitochondrial DNA (mtDNA) analysis were performed in order to identify the mitochondrial clade. Screening of louse-borne pathogens bacteria was based on targeting specific genes for each pathogen using qPCR supplemented by sequencing. All body lice belong to clade A. Through amplification and sequencing of the cytb gene we confirmed the presence of three haplotypes: A5, A9 and A63, which is novel. The molecular investigation of the 524 body lice samples revealed the presence of four human pathogens: Bartonella quintana (13.35%), Coxiella burnetii (10.52%), Anaplasma phagocytophilum (0.76%) and Acinetobacter species (A. baumannii, A. johnsonii, A. berezeniae, A. nosocomialis and A. variabilis, in total 46.94%).

CONCLUSIONS/SIGNIFICANCE

To the best of our knowledge, our study is the first to show the genetic diversity and presence of several emerging pathogenic bacteria in homeless' body lice from Algeria. We also report for the first time, the presence of several species of Acinetobacter in human body lice. Our results highlight the fact that body lice may be suspected as being a much broader vector of several pathogenic agents than previously thought. Nevertheless, other studies are needed to encourage epidemiological investigations and surveys of louse-associated infections.

Bartonella quintana, an Unrecognized Cause of Infective Endocarditis in Children in Ethiopia

Bartonella quintana endocarditis, a common cause of culture-negative endocarditis in adults, has rarely been reported in children. We describe 5 patients 7-16 years of age from Ethiopia with heart defects and endocarditis; 4 cases were caused by infection with B. quintana and 1 by Bartonella of undetermined species. All 5 patients were afebrile and oligosymptomatic, although 3 had heart failure. C-reactive protein was normal or slightly elevated, and erythrocyte sedimentation rate was high. The diagnosis was confirmed by echocardiographic demonstration of vegetations, the presence of high Bartonella IgG titers, and identification of B. quintana DNA in excised vegetations. Embolic events were diagnosed in 2 patients. Our data suggest that B. quintana is not an uncommon cause of native valve endocarditis in children in Ethiopia with heart defects and that possible B. quintana infection should be suspected and pursued among residents of and immigrants from East Africa, including Ethiopia, with culture-negative endocarditis.

The epidemic typhus and trench fever are risk for public health due to increased migration in southeast of Turkey

Pediculus humanus capitis is a small ectoparasitic insect that has lived and feds on human beings for thousands of years. Molecular techniques have been used for Pediculus species identification and evolutionary, phylogenic, and ecological studies. A total of 23 adults of P. h. capitis were collected in Gaziantep, located in southeast Turkey, and DNA was isolated from all P. h. capitis using DNA extraction kit. All DNA samples were screened for investigate of Ricettsia prowazekii, Bartonella quintana and Borrelia recurrentis with real-time polymerase chain reaction. In addition, we investigated genetic variation in DNA samples of Pediculus humanus capitis using the cytochrome oxidase I genetic DNA sequence. We found 4 (17.4%) Ricettsia prowazekii and 3 (13.1%) Bartonella quintana in DNA samples of Pediculus humanus capitis, while we did not find any Bartonella recurrentis in any of the DNA samples. We demonstrated 1.8% genetic variations in DNA samples of Pediculus humanus capitis with Bartonella quintana. The phylogenetic tree based on the cytochrome oxidase I gene revealed that P. h. capitis in southeast Turkey are classified into two clades (clade A, clade B) and Bartonella quintana was found in only clade B. However, we did not find any genetic variations in other DNA samples in this region. The genetic variations may be related to P. h.capitis vector of Bartonella quintana has found in this study. In addition, this study was shown that P. h. capitis do transmit Rickettsia prowazekii and Bartonella quintana to people, epidemic typhus and trench fever may emergence in Gaziantep southeast of Turkey in the future.

Tick-, Flea-, and Louse-Borne Diseases of Public Health and Veterinary Significance in Nigeria

Mosquito-borne diseases are common high-impact diseases in tropical and subtropical areas. However, other non-mosquito vector-borne pathogens (VBPs) may share their geographic distribution, seasonality, and clinical manifestations, thereby contributing their share to the morbidity and mortality caused by febrile illnesses in these regions. The purpose of this work was to collect and review existing information and identify knowledge gaps about tick, flea-, and louse-borne diseases of veterinary and public health significance in Nigeria. Full-length articles about VBPs were reviewed and relevant information about the vectors, their hosts, geographic distribution, seasonality, and association(s) with human or veterinary diseases was extracted. Specific laboratory tools used for detection and identification of VBPs in Nigeria were also identified. A total of 62 original publications were examined. Substantial information about the prevalence and impacts of ticks and fleas on pet and service dogs (18 articles), and livestock animals (23 articles) were available; however, information about their association with and potential for causing human illnesses was largely absent despite the zoonotic nature of many of these peri-domestic veterinary diseases. Recent publications that employed molecular methods of detection demonstrated the occurrence of several classic (Ehrlichia canis, Rickettsia africae, Bartonella sp.) and emerging human pathogens (R. aeschlimannii, Neoehrlichia mikurensis) in ticks and fleas. However, information about other pathogens often found in association with ticks (R. conorii) and fleas (R. typhi, R. felis) across the African continent was lacking. Records of louse-borne epidemic typhus in Nigeria date to 1947; however, its current status is not known. This review provides an essential baseline summary of the current knowledge in Nigeria of non-mosquito VBPs, and should stimulate improvements in the surveillance of the veterinary and human diseases they cause in Nigeria. Due to increasing recognition of these diseases in other African countries, veterinary and public health professionals in Nigeria should expand the list of possible diseases considered in patients presenting with fever of unknown etiology.

Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis

Since the reclassification of the genus Bartonella in 1993, the number of species has grown from 1 to 45 currently designated members. Likewise, the association of different Bartonella species with human disease continues to grow, as does the range of clinical presentations associated with these bacteria. Among these, blood-culture-negative endocarditis stands out as a common, often undiagnosed, clinical presentation of infection with several different Bartonella species. The limitations of laboratory tests resulting in this underdiagnosis of Bartonella endocarditis are discussed. The varied clinical picture of Bartonella infection and a review of clinical aspects of endocarditis caused by Bartonella are presented. We also summarize the current knowledge of the molecular basis of Bartonella pathogenesis, focusing on surface adhesins in the two Bartonella species that most commonly cause endocarditis, B. henselae and B. quintana. We discuss evidence that surface adhesins are important factors for autoaggregation and biofilm formation by Bartonella species. Finally, we propose that biofilm formation is a critical step in the formation of vegetative masses during Bartonella-mediated endocarditis and represents a potential reservoir for persistence by these bacteria.

Detection of bacterial pathogens including potential new species in human head lice from Mali

In poor African countries, where no medical and biological facilities are available, the identification of potential emerging pathogens of concern at an early stage is challenging. Head lice, Pediculus humanus capitis, have a short life, feed only on human blood and do not transmit pathogens to their progeny. They are, therefore, a perfect tool for the xenodiagnosis of current or recent human infection. This study assessed the occurrence of bacterial pathogens from head lice collected in two rural villages from Mali, where a high frequency of head lice infestation had previously been reported, using molecular methods. Results show that all 600 head lice, collected from 117 individuals, belonged to clade E, specific to West Africa. Bartonella quintana, the causative agent of trench fever, was identified in three of the 600 (0.5%) head lice studied. Our study also shows, for the first time, the presence of the DNA of two pathogenic bacteria, namely Coxiella burnetii (5.1%) and Rickettsia aeschlimannii (0.6%), detected in human head lice, as well as the DNA of potential new species from the Anaplasma and Ehrlichia genera of unknown pathogenicity. The finding of several Malian head lice infected with B. quintana, C. burnetii, R. aeschlimannii, Anaplasma and Ehrlichia is alarming and highlights the need for active survey programs to define the public health consequences of the detection of these emerging bacterial pathogens in human head lice.

Human Lice in Paleoentomology and Paleomicrobiology

Lice are a classic example of cospeciation. Human lice confirm this cospeciation with lice specialized in hominids which differ from those of gorillas and chimpanzees. Head lice and body lice seem to belong to closely related species with different ecotypes and a different geographical distribution which may reflect population movements. Paleo-entomology allows us in some cases to trace the migrations of archaic human populations. The analysis of lice found on mummies in Egypt and South America has clarified a certain number of these migrations, also the study of lice and the diseases they transmit has shed a new light on the epidemics of the past.

Bacterial arthropod-borne diseases in West Africa

Arthropods such as ticks, lice, fleas and mites are excellent vectors for many pathogenic agents including bacteria, protozoa and viruses to animals. Moreover, many of these pathogens can also be accidentally transmitted to humans throughout the world. Bacterial vector-borne diseases seem to be numerous and very important in human pathology, however, they are often ignored and are not well known. Yet they are in a phase of geographic expansion and play an important role in the etiology of febrile episodes in regions of Africa. Since the introduction of molecular techniques, the presence of these pathogens has been confirmed in various samples from arthropods and animals, and more rarely from human samples in West Africa. In this review, the aim is to summarize the latest information about vector-borne bacteria, focusing on West Africa from 2000 until today in order to better understand the epidemiological risks associated with these arthropods. This will allow health and veterinary authorities to develop a strategy for surveillance of arthropods and bacterial disease in order to protect people and animals.

Molecular Markers of Pesticide Resistance and Pathogens in Human Head Lice (Phthiraptera: Pediculidae) From Rural Georgia, USA

Although the head louse, Pediculus humanus capitis De Geer, and body louse, Pediculus humanus humanus L., both have a worldwide distribution, the occurrence of head louse pediculosis appears to be more prevalent in modern societies despite systematic use of various pediculicides. This study tested head lice collected in rural Georgia and body lice collected in Russia for the prevalence of a kdr-biomarker that is associated with permethrin resistance. This study also screened lice for the presence of DNA from Bartonella quintana and Acinetobacter species. The kdr-permethrin resistance biomarker for the T917I mutation was detected by RFLP and PCR in 99.9% of head lice tested from Georgia, whereas only 2.9% of body lice from Russia tested positive for this kdr biomarker. DNA of B. quintana was detected in 10.3% of head lice from Georgia, whereas 84.8% of body lice from Russia tested positive. Acinetobacter DNA was detected in 80.8% (95% CI, 68-89%) of head lice from Georgia and all body lice from Russia tested.

Human head lice and pubic lice reveal the presence of several Acinetobacter species in Algiers, Algeria

There are two majorspecies of medically important lice that parasitize humans: Phthirus pubis, found in pubic hair, and Pediculus humanus. Pediculus humanus consists of two eco types that live in specific niches on the human host: body lice (Pediculus humanus humanus), found on the human body and clothing, and head lice (Pediculus humanus capitis), found on the scalp. To date, only body lice are known to be vectors of human disease; however, it has recently been reported that the DNA of several bacterial agents has been detected in head lice, raising questions about their role in the transmission of pathogens. This issue caught our attention, in addition to the fact that the pathogenic bacteria associated with P. pubis and P. humanus capitis have never been investigated in Algeria. To investigate this,molecular techniques (real-time PCR) were used to screen for the presence of Acinetobacter spp., Bartonella spp., Borrelia spp. and Rickettsia prowazekii DNA from P. humanus capitis (64 lice) collected from schoolchildren,and P. pubis (4 lice),collected from one adultman living in Algiers. Positive samples for Acinetobacter spp.were identified by sequencing therpoBgene. Conventional PCR targeting the partial Cytb gene was used to determine the phylogenetic clade of the collected lice. Of the 64 samples collected, Acinetobacter spp. DNA was detected in 17/64 (27%) of head lice, identified as: A. baumannii (14%), A. johnsonii (11%) and A. variabilis (2%). Of the four P. pubissamples, 2(50%) were positive for A. johnsonii. The phylogenetic tree based on the Cytb gene revealed that P. humanus capitis were grouped into clades A and B. In this study, we report andidentify for the first time Acinetobacter spp.in Algerian P. pubis and P. humanus capitis. The detection of the genus Acinetobacter in lice should not be underestimated, especially in P. humanus capitis, which is distributed worldwide. However, additional epidemiological data are required to determine if human lice may act as an environmental reservoir and are actively involved in the propagation of these bacteria to humans.

Elucidating transmission dynamics and host-parasite-vector relationships for rodent-borne Bartonella spp. in Madagascar

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At least five distinct species of Bartonella infect R. rattus rodents and their ectoparasites in Madagascar.

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Infection dynamics for zoonotic B. elizabethae are consistent with an SIS or SIR model in rodent hosts.

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Infection dynamics for non-zoonotic B. phoceensis & rattimassiliensis are consistent with an SI model in rodent hosts.

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Transmission of B. elizabethae and B. phoceensis & rattimassiliensis, respectiviely, are affected by S. fonquerniei & X. cheopsis fleas and Polyplax spp. lice.

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S. fonquerniei/X. cheopsis fleas may vector B. elizabethae and Polyplax spp. lice vector B. phoceensis/rattimassiliensis.

Bartonella spp. are erythrocytic bacteria transmitted via arthropod vectors, which infect a broad range of vertebrate hosts, including humans. We investigated transmission dynamics and host-parasite-vector relationships for potentially zoonotic Bartonella spp. in invasive Rattus rattus hosts and associated arthropod ectoparasites in Madagascar. We identified five distinct species of Bartonella (B. elizabethae 1, B. elizabethae 2, B. phoceensis 1, B. rattimassiliensis 1, and B. tribocorum 1) infecting R. rattus rodents and their ectoparasites. We fit standard epidemiological models to species-specific age-prevalence data for the four Bartonella spp. with sufficient data, thus quantifying age-structured force of infection. Known zoonotic agents, B. elizabethae 1 and 2, were best described by models exhibiting high forces of infection in early age class individuals and allowing for recovery from infection, while B. phoceensis 1 and B. rattimassiliensis 1 were best fit by models of lifelong infection without recovery and substantially lower forces of infection. Nested sequences of B. elizabethae 1 and 2 were recovered from rodent hosts and their Synopsyllus fonquerniei and Xenopsylla cheopsis fleas, with a particularly high prevalence in the outdoor-dwelling, highland-endemic S. fonquerniei. These findings expand on force of infection analyses to elucidate the ecological niche of the zoonotic Bartonella elizabethae complex in Madagascar, hinting at a potential vector role for S. fonquerniei. Our analyses underscore the uniqueness of such ecologies for Bartonella species, which pose a variable range of potential zoonotic threats.

Head Lice of Pygmies Reveal the Presence of Relapsing Fever Borreliae in the Republic of Congo

BACKGROUND

Head lice, Pediculus humanus capitis, occur in four divergent mitochondrial clades (A, B, C and D), each having particular geographical distributions. Recent studies suggest that head lice, as is the case of body lice, can act as a vector for louse-borne diseases. Therefore, understanding the genetic diversity of lice worldwide is of critical importance to our understanding of the risk of louse-borne diseases.

METHODOLOGY/PRINCIPAL FINDINGS

Here, we report the results of the first molecular screening of pygmies' head lice in the Republic of Congo for seven pathogens and an analysis of lice mitochondrial clades. We developed two duplex clade-specific real-time PCRs and identified three major mitochondrial clades: A, C, and D indicating high diversity among the head lice studied. We identified the presence of a dangerous human pathogen, Borrelia recurrentis, the causative agent of relapsing fever, in ten clade A head lice, which was not reported in the Republic of Congo, and B. theileri in one head louse. The results also show widespread infection among head lice with several species of Acinetobacter. A. junii was the most prevalent, followed by A. ursingii, A. baumannii, A. johnsonii, A. schindleri, A. lwoffii, A. nosocomialis and A. towneri.

CONCLUSIONS/SIGNIFICANCE

Our study is the first to show the presence of B. recurrentis in African pygmies' head lice in the Republic of Congo. This study is also the first to report the presence of DNAs of B. theileri and several species of Acinetobacter in human head lice. Further studies are needed to determine whether the head lice can transmit these pathogenic bacteria from person to another.

High Ancient Genetic Diversity of Human Lice, Pediculus humanus, from Israel Reveals New Insights into the Origin of Clade B Lice

The human head louse, Pediculus humanus capitis, is subdivided into several significantly divergent mitochondrial haplogroups, each with particular geographical distributions. Historically, they are among the oldest human parasites, representing an excellent marker for tracking older events in human evolutionary history. In this study, ancient DNA analysis using real-time polymerase chain reaction (qPCR), combined with conventional PCR, was applied to the remains of twenty-four ancient head lice and their eggs from the Roman period which were recovered from Israel. The lice and eggs were found in three combs, one of which was recovered from archaeological excavations in the Hatzeva area of the Judean desert, and two of which found in Moa, in the Arava region, close to the Dead Sea. Results show that the head lice remains dating approximately to 2,000 years old have a cytb haplogroup A, which is worldwide in distribution, and haplogroup B, which has thus far only been found in contemporary lice from America, Europe, Australia and, most recently, Africa. More specifically, this haplogroup B has a B36 haplotype, the most common among B haplogroups, and has been present in America for at least 4,000 years. The present findings confirm that clade B lice existed, at least in the Middle East, prior to contacts between Native Americans and Europeans. These results support a Middle Eastern origin for clade B followed by its introduction into the New World with the early peoples. Lastly, the presence of Acinetobacter baumannii DNA was demonstrated by qPCR and sequencing in four head lice remains belonging to clade A.

Management and Treatment of Human Lice

Of the three lice (head, body, and pubic louse) that infest humans, the body louse is the species involved in epidemics of louse-borne typhus, trench fever, and relapsing fever, but all the three cause pediculosis. Their infestations occur today in many countries despite great efforts to maintain high standards of public health. In this review, literature searches were performed through PubMed, Medline, Google Scholar, and EBSCOhost, with key search words of "Pediculus humanus", "lice infestation", "pediculosis", and "treatment"; and controlled clinical trials were viewed with great interest. Removing lice by hand or with a lice comb, heating infested clothing, and shaving the scalp were some of the oldest methods of controlling human lice. Despite the introduction of other resources including cresol, naphthalene, sulfur, mercury, vinegar, petroleum, and insecticides, the numbers of lice infestation cases and resistance have increased. To date, viable alternative treatments to replace insecticides have been developed experimentally in vitro. Today, the development of new treatment strategies such as symbiotic treatment and synergistic treatment (antibiotics + ivermectin) in vitro has proved effective and is promising. Here, we present an overview on managing and treating human lice and highlight new strategies to more effectively fight pediculosis and prevent resistance.

A New Clade of African Body and Head Lice Infected by Bartonella quintana and Yersinia pestis-Democratic Republic of the Congo

The human body louse is known as a vector for the transmission of three serious diseases-specifically, epidemic typhus, trench fever, and relapsing fever caused by Rickettsia prowazekii, Bartonella quintana, and Borrelia recurrentis, respectively-that have killed millions of people. It is also suspected in the transmission of a fourth pathogen, Yersinia pestis, which is the etiologic agent of plague. To date, human lice belonging to the genus Pediculus have been classified into three mitochondrial clades: A, B, and C. Here, we describe a fourth mitochondrial clade, Clade D, comprising head and body lice. Clade D may be a vector of B. quintana and Y. pestis, which is prevalent in a highly plague-endemic area near the Rethy Health District, Orientale Province, Democratic Republic of the Congo.